Podcast Episode #28 With Great Educational Power, Comes Great Educational Responsibility



Jamie Johnston 0:12
You’re listening to the massage therapist Development Initiative. I’m Jamie Johnston.

Eric Purves 0:17
And I’m Eric Purves. This is a podcast by massage therapists for massage therapists.

Jamie Johnston 0:22
Our objective is to simplify how to be a more evidence informed practitioner. Let’s dig into this episode of education, education, education, I was told as a young man that you say things three times as a repetition for emphasis. However, when we look at the emphasis that is being put on our education, by many of the conferences and things that we see across across Canada, in the US and other places, all too often. We’re never learning from RMTS. And we’re not promoting other massage therapists to step up and present at these conferences, and we’re learning from people who don’t do what we do. And as we have said so many times before, we believe that that’s something that needs to drastically change within our profession.

Eric Purves 1:19
Definitely, and this is a conversation that we’ve had before in a previous one, I think we had one called RMTS, learning from RMTS. And I think it’s really important for us to, to kind of keep hammering that point home, right, the repetition, repetition, repetition, is is really is important. And, you know, the, for too long, we both believe and I can speak for myself, I won’t speak for you right now, Jamie, but we’ve looked at the professionals look outwards, right look upwards towards different health care providers, to look for leadership and to look for guidance on on, you know, things like best practices or different approaches, or, you know, the incorporating the research into practice that type of thing. But we now have, I think we’re at a time in the profession where we are at a point in time where we can, we should be taking the lead ourselves and stop looking at words. And, you know, when the I remember saying this quite a few years ago, I’m gonna say about four or five years, I was having a conversation with a colleague. And I basically said, you know, why is there not more arm T’s presenting at conferences? Why isn’t it more on T’s, teaching these continuing education courses? And the answer I got was, because there’s not really enough good quality RMTS out there. Now good quality, meaning as educators is to teach kind of current best practice type stuff. And I remember thinking, Oh, well, let’s seems to be a problem. But I never really thought about it much more than that. And the courses I took, oftentimes, were not by our own teachers, because that was what was available that we met my interest. But now we look at the amount of good quality evidence based educators out there that are starting to take the lead, we should really move towards that where we started looking to learn from within rather than looking outwards. And there is in a lot of levels, a lot of ways some of the associations are doing really well listen, some are not doing as well as we would expect.

Jamie Johnston 3:20
Yeah. Yeah. And I think we, we chatted about it a little bit before we got on but but before we get into who we’re gonna say, is doing a good job, just to add to what you were saying, the other thing that we’re starting to see is that people from some of those other professions are now coming in and challenging our exams, or they’re taking a bridge course, to become an RMT. So that they can get in to teach RMTS or massage therapists, not, you know, not just strictly, you know, people in our province, but we see, you know, some chiropractors and athletic therapists and different professions that are going in wanting to get to the title of massage therapist so that they can get into teaching massage therapists and with only that goal in mind, not to actually advance the profession and to be to be a you know, a better manual therapist or hands on therapist or anything like that. So I think we also need to look at like, okay, what are the motives behind some, some of the ones who are doing that? And is that where we should be looking for our courses?

Eric Purves 4:36
Yeah, that’s a great point, actually. Yeah. What’s the motivation for why would you want to do that? Right. So if you are, say, a chiropractor, or athletic therapist, which are I think probably the two most competitive athletic therapists probably the most common, there are

Jamie Johnston 4:48
certainly a lot more of them and many of them are doing it not necessarily become teachers but because they they don’t get the the insurance coverage and things like that like an RMT does. So they do that to you. To be able to make more money billing out,

Eric Purves 5:02
because because they’re unregulated, they don’t have like a body to advocate or for insurance. Yeah. So which makes sense, right? You’re, you know, you’ve got the your education, and you’re really great at, you know, assessment and musculoskeletal rehab stuff from like, say, being an athletic therapist, but then you can’t, you’re like, if I’m not busy, because I have people have to pay out of pocket, and they can get something maybe similar from somebody else or that person get reimbursed. So that makes sense. But I think yeah, with what you’re saying that with, with the motivation as to why I want to have this title, I want to add the RMT designation, after seeing my chiropractic for, for example, the Yeah, why are you doing that? Right, other than to maybe just try to be like, Yeah, I’m one of you as well. Yeah. But I don’t understand why somebody would want to challenge the exam. I mean, I’d like to, that’d be something I’d be very interested to hear more about that. Yeah. I was Why would you challenge the exam? If you’re just like, are you actually going to build for massage therapy, or just want to put that in your course type in your bio when you’re teaching? I don’t know. It’s, it’s an interesting thing. And I, if someone listening hasn’t answered for that be great.

Jamie Johnston 6:14
Yeah. I’m not sure. Yeah. But I think it’s still it sort of goes back to that thing is if you went and did that, just so that you can get into teaching gigs, to teach other massage therapists, then I think as people who are taking the courses, we should be analyzing that before we take the course. Because we firmly believe that the more that we can build up other people within our profession to become educators, and the more that we can learn from each other, then the better off that is for the profession. For sure, for sure.

Eric Purves 6:46
And also to uh, you almost wonder, though, hey, like, what does it say about our profession? When we can’t go challenge somebody else’s board exam unless we unless we go through their entire curriculum? Why is it? For some reason, our profession is the only one we’re like, Oh, your physiotherapist, your therapists, your chiropractor, your naturopath you’ve got you’ve got education. Okay, just right, just right, our exam if you pass it, yeah, go ahead.

Jamie Johnston 7:11
It should be mandatory that you have to go through the full program, because it’s the same with we will try to do it in another program.

Eric Purves 7:16
Yeah, I remember back when I first started looking into being a massage therapist in the late 90s, early 2000s, date myself here a little bit, I remember the guy that I used to get massage from was actually an athletic therapist, and back then you could go to, you could just challenge the exam, whenever you want it, you go to cmtbc and challenge it. And then they got rid of that for a long time. You couldn’t challenge it right? You had to go through the program. And if you made the word RMT, outside of BC, and maybe you moved here from Ontario, you could then do like a upgrade. Yeah, bridging them. There’s been a couple people in my school that were great therapists, but they had to jump through the hoops, but they went and they got licensed here. For some reason. I’m sure there’s somebody that might listen, that might know the reason why. But from a, from a logical perspective, it doesn’t make any sense. Why somebody could just come in and challenge the exam, I understand that, hey, if you’re not RMT, anywhere in Canada, you shouldn’t be able to move again, aren’t you? You’re an RMT you’ve been to school in Canada and regulated province. Education is gonna be very similar based on knowledge and very similar. Yeah, like don’t make it difficult people. But if you’re in a different profession, you’ve never actually been through a you’re not educated as a massage therapist. And you haven’t had that clinical practice, yet. Like if you’re just doing exercise rehab and, you know, spinal adjustments, and then you go and try and massage somebody. You know, and you don’t have the experience, like how many hundreds of hours you’re you’re working with your classmates and your clinic and all that stuff? I think, I don’t know, I decided to I think it doesn’t say a lot enough. It’s not a positive thing for our profession to be. Say, oh, yeah, come on in and pass the test. Here you go. Here’s your title. Absolutely.

Jamie Johnston 9:02
Because it’s funny, because I know some people who have gone to challenge the test to ask me to teach them how to drape people. Right? Because like something as simple as that, that’s so simple to us, is not something that they’ve ever done in any of those other professions. But anyways, that’s a that’s a bit of a rant about that, but I think they have changed it and you have to go and get schooling now. I don’t think you can just go in and challenge the examiner. I keep going back and forth. flip flopped. Yeah, yeah. And I think and I could be totally wrong. But I think part of the reason was because the the college would refer back to the schools. And it was the schools who said no, no, they’ve got to come and take at least our Bridging Program. Okay. Right. I think that’s how it happened. But don’t quote me on it. Because I 100% can be wrong. Yeah.

Eric Purves 9:52
We both are wrong a couple of times. Every day. Yeah, less wrong, hopefully. Yeah. So So yeah, let’s let’s Talk about some of the we just kind of preparing for this talk we had this episode, we looked through just some of the upcoming or past conferences that some of the associations put on across the country. And just, and just looking at seeing how the associations are doing in terms of who’s presenting and the kind of content that they’re they’re presenting on. And, you know, we’ll kind of I think we’ll just kind of provide some opinions and ideas about some of these things. And then maybe, you know, believe the final decision to be made by the listener about how they feel

Jamie Johnston 10:32
totally. So one of the and I’m just looking at their webpage now. But one of the things, one of the ones that we thought are doing a great job is the the RMTAO. So the Massage Therapy Association of Ontario, and if you look at the conference that they’re putting on, every single presenter is an RMT. Except for the keynote, okay, which is a doctor, okay. Which is, I mean, kind of a cool, good co host of a CBC radio show and veteran emergency room physician. That’s right up my alley is first responder. But yeah, when you look down that list, it’s all RMTS, which is great. And I wish more more associations would look at that and go, that’s what we should be doing. We should be building up the people in our profession, in our province, or state, or whatever it is, wherever you live, that we want to get these people up to show what we can do as a profession, but also to show what other people in the profession could possibly do. Because the more that we promote other RMT stepping up, and educating and educating, getting more education for themselves, and bringing that content to the rest of us. It doesn’t just benefit the profession. It benefits the general public, which is what we should all want.

Eric Purves 12:00
It’s everyone’s best interest. Totally. Yeah. Yeah, I think and I think I think that the RTO is doing a much better job than they were I think they I don’t know why. But they used to only do their conferences every second year. I think they are doing them every year now. I was a presenter there in 2018, or 19. I can’t remember one of few years ago, and their keynote then was Melanie Knoll. And that was her first keynote she did for a manual therapy. Conference, first first time I encountered her so I don’t whatever was 18 or 19. Can’t remember. But then all that time to they had every single presentation there was done by RMTS. And that seems to be something consistently, you know, and then just looking through their what they have here they’re on to which, which makes me very happy to see is is they have the keynote, and it looks like they break it down into they have three different kinds of overlap, like plenary sessions, which which go all kind of at the same time, say the Business Strategy Session. They have an interprofessional collaboration session, and they have evidence based practice sessions. So pretty cool stuff really important. I think it’s really important for us as arm T’s. The only thing I don’t like about this, this this format, is that you could miss something.

Jamie Johnston 13:19
Yeah, if you’re focused on one area, you could miss out on really important information and the other one,

Eric Purves 13:25
like I’m just looking at one here, this is this is this is just my bias coming out here. But I look at it at the end of the day, they at the same time they have one working within an MBA care team for solo practitioners by Danny Felcher. We both know, but at the same time, you also got Richard Lieber doing one chronic pain evidence based person centered approach. So like, well, I find to see both of those. You couldn’t use this one. And I don’t know if this recording you get access to recordings afterwards. But I know for me, oftentimes I get recordings from things and I don’t really watch them.

Jamie Johnston 13:54
Yeah. Lost with other things. And

Eric Purves 13:57
yeah, he’s busy. So that’s the only thing I would say that is that I was like, oh, it’d be nice if it was like a two day conference. I don’t know if it’s expensive or these things are expensive. But yeah. But that you look at that you look at the content of the stuff they’re doing here, right, they’ve got, you know, stuff on and this is by no order of importance, but just looking at it here they got, you know, things that appeal to me is how to assess the impact of trauma safely. So keeping clients safe so they’re kind of trauma informed practice stuff. Mastering difficult conversations to be a great one. Be a great one right. Opening the doors to collaborative healthcare introduction evidence based practice by PCs own Bodhi who we know and then yeah, and then you have these other ones talking about the working with MBA care team and chronic pain. Which is which is great. And I bet you the Richards chronic pain when he was probably just to promote it. We just published paper together. So I’m promoting that the other day. Yeah. And I was one of the authors on that. So I’m assuming that part of the what he’s in present there is on that And that was his. That was his baby. He took the lead on that. So I think I’d like to see his presentation on that. Anyway, pretty cool stuff and RMT forward, right? Very RMT focused actually,

Jamie Johnston 15:11
especially like when you look at the title of Danny’s presentation, working within an MVA care team for solo practitioners. And I know like, how much frustration do we have especially like, when we’ve been teaching courses over the years and communicating with people where they’re like, Well, yeah, but I’ve got this person that’s come to me then they go to a Chiro then they go over to their physio, and then they go to their doctor, and they’re going to five appointments a week in all different places. So what a what a great topic of something to be like, Okay, how do I work together with these other practitioners when I’m in a silo in my own clinic or whatever? Like, very, very RMT approach?

Eric Purves 15:45
Yeah, yeah. I and this is this is great, too. And they had their panel discussions as creating an inclusive healthcare practices is another really important kind of thing that’s finally being talked about is this inclusivity and I’m just looking to see and I can’t see it off top my head here. Who is? Who is in that?

Jamie Johnston 16:05
It’s Damien John. Oh, doctor, Dr. Alex Abramovich. Hopefully I’m crucifying the gentleman’s name Sharon Davis Murdoch. Who’s a cm I don’t know what cm stands for?

Eric Purves 16:20
Yeah, I don’t know, either. And Damien, who you know, and other BC former, or as he’s still an RMT? I’m not sure. Anyway,

Jamie Johnston 16:29
I don’t think he’s practicing anymore.

Eric Purves 16:32
And then you had another person, Jessica city, who I don’t know, but you got a couple of RMTS in here. And people who look like they have kind of special focus or education or advocacy and that kind of inclusive healthcare practice, which is great. These are conversations that need to be had, and information needs to get out there. So it’s good that these things are happening. I Yeah. So I don’t really have any, I don’t have anything bad to say about that. What I do oh, well, what we’ll just keep pumping up the tires of their RMTAO do I mean, we’re not members of them? So I don’t I’ve never paid it was there anything. So I’m just going based on what we see. But also, when you look at their their website, this is really great as they have a whole thing on education and events, where you can actually add a course listing, you can you can actually make a request for them. And I know they do, I think monthly webinars available for members. So you could say, hey, you know, Jamie, you could go in there, hey, I want to do one on fear avoidance model. And why this is important for massage therapists, you could go and request for them to do that. And they would promote it. Which is to being an advocate for the profession for the members to build up the profession, to be leaders. And I love that and and we don’t see that as much unfortunately, with many of the other associations.

Jamie Johnston 17:51
Yeah. Yeah. And one thing I’ll say, too, is that they, from the things that I’ve seen, is they’ve done a really good job with their social media, promoting evidence based things and, you know, different. Not means but what am i What’s the thing I’m trying to think of? Where it’s like, like, pictographs of things that are evidence based? Yeah, like different graphics, and things like that, that are promoting evidence based practice and things and, and I know, there’s been a couple of times I’ve seen them promote something where people call that out, and they’re like, this isn’t cool. But for the most part, the things that I’ve seen, I’d say they’re doing a really good job with their social media and things.

Eric Purves 18:29
Yeah, I really liked their their social media stuff, too, I find that it’s like what they do. Okay, portion, like being with a bias of the RMT focuses, they do seem to share a lot of posts made by their members. So good quality information, good quality information, and they seem to be doing, you know, being advocates for as much as they can for their for their members. Yep. Yeah. And, you know, what I would like to see is I would like to see them do more, all Association, but I would like to see them do more of that. But also, I think we really good. I mean, these guys have money to spend, right? Like we you know, maybe we should make this statement. We are former board on the board of directors with the arm TVC. So our opinions expressed here are not necessarily those of MTV seeds, and we’ll get that out of the way. But the would be nice. And actually, I would like to see them do more like Facebook ads. Like it’s not very expensive. If you’ve got a web team to do stuff out to promote, say, Hey, here’s something that one of our members did, or here’s something that you know, a paper that was published or here’s a something that the association has done.

Jamie Johnston 19:54
Yeah. And show the benefit of what you’re the benefit of

Eric Purves 19:57
it. Because when you just make these passive posts It’s on like, you know, business page on Facebook, for any of us that use business pages on Facebook, you have to interact like on a very regular basis in order just to get it to get it built up. And in order to get it to show up people’s feeds, Facebook ads, it’ll, it’ll go to anybody. Well, and that is a massage therapist, for example, within, like you’ve been targeted, I would like to see that more so that way you could lose as RM TVC memories like, Well, yeah, what are you doing? Like, I have to go searching for it? And never, it’s never like, delivered to me.

Jamie Johnston 20:31
Yeah, well, and my opinion, too, is that every Association should have their own Facebook page. Yeah. You know, as somebody who’s a member, you can go on to that page and ask questions about your practice and get a legitimate answer from somebody within the association, whether it’s like a practice advisor, or whether it’s, you know, if you just have questions about your membership, that you can get the answers to that on that page. And it’s monitored so that people who aren’t members aren’t on that page. And it’s only delivered to the people who are members. Because, you know, there’s so many different options for Facebook pages out there that anybody can just open up a massage therapy Facebook page for their province, and you’re not necessarily getting accurate information and accurate advice, according to your practice on there. Whereas, you know, if you had a practice advisor in place, part of their job could be to log on and look at that page every day and answer whatever questions are coming in and have that discussion. So that people are getting accurate information.

Eric Purves 21:36
And I do see, I did see the other day that at least at NBC, they are actually hiring a practice advisor a full time. Job. So I don’t know why I didn’t read through it in depth. But that would be that would be ideal, right? Because what I find with the way a lot of the the association or they kind of work in this, like an older model of like, it is way things were done 20 years ago, 15 years ago with email, and you know, mail outs and stuff, but having a social media presence, in today’s day and age is what a lot of people want. And I know for me personally, like I will go on Facebook or Instagram often to look for information, or that’s where I get a lot of, you know, things that they’re looking for to find something I’ll often go there first, yeah, you see if someone’s posted, if there’s a length or something, it’d be lovely to have that as a resource.

Jamie Johnston 22:27
Only, and I mean, be able to go in, you know, if you had that practice advisor that once a week could go in and drop in a research paper and be like, Hey, here’s the paper that really applies to your practice, give this one a read. And, you know, put some bullet points in there of like, what it covers? Yeah, simple stuff like that, I think would go a long way to the user experience of the people who are members of associations.

Eric Purves 22:51
Definitely, definitely. And that would that would be that would be ideal. I think that would be that would be ideal. But yeah, I do like that the arm to come back to that point is like did a really good job of promoting good evidence based practice to the members, right. And if I think that the leadership needs to take a role in changing kind of some of these unhelpful, common narratives within the profession, we’ve talked with this probably every episode before, about, you know, the, the leadership about, you know, changing curriculums or updating best practice, or educating the profession should come from the associations, and then the associations trying to, you know, provide resources or influences to the to the school, so then that information can then be adopted and taken into the curriculum. And then you can put that upward pressure on the colleges and say that the regulatory bodies, regulatory colleges say, Hey, here’s, this is what we want to be teaching. This is consistent within our scope of practice. Let’s update Let’s Let’s update our competency documents. And I all I hear, we’ve probably talked about it was a million times, and we probably talked about it many times on the on the This podcast is pointing, what you often hear is finger pointing and excuses rather than somebody being like, Yeah, let’s do this. Yeah, there’s stakeholders to make it happen. And everyone’s like, why we’re not gonna do this on our response, but it’s their responsibility. That person says, No, it’s not my responsibility to responsibility. It’s a circle of circle. And it’s been this conversations been happening forever, right? Everyone kept blaming somebody else. And I would say, to RMTS, to be leaders of our own teams, we need our associations, we need your stakeholders, we need the colleges to take a leadership role, to promote the profession, to deliver good quality, evidence based curriculum that’s within our scope of practice. And then to use things like these conferences, to show the great work that massage therapists are doing, and promote that content and promote that content. Right, like the rmta, who’s doing a great job promoting that content. I think it’s just great.

Jamie Johnston 24:51
Which is funny because this is this is also on the outside looking in and there could be people who are rmta or members that would listen to this and go what are you talking about? They’re doing a shit job, right? Yeah, maybe differences of opinion, but this is just what we’re seeing from the outside looking at so. So yeah, props to the rmta over what we see them doing. Yeah. Yeah. However, you know, across North America also because I don’t see much in the way of like New Zealand or Australia and conferences that they do over there or if they even do them.

Eric Purves 25:25
No idea. I’m sure they do. I just it’s Yeah, but I

Jamie Johnston 25:28
just don’t see it. But you know, so I’m talking to a few friends that are AMTA members, I know that there’s, there’s a bit of a push happening in the states to get things changed around to be, you know, some more evidence-based courses and things like that. I haven’t noticed a lot about who they bring in for presenters. But but it sort of goes back to the same thing that all too often we’re relying on people who are not in the profession to be presenters at these things. And that really, really needs to change. Because how do you, you know, you wouldn’t, you wouldn’t go to a mechanic and try to learn how to do an oil change, and bring in a geologist to do it. To educate you on how to do it. Yeah. So why are why are we still bringing in a different profession? To teach us how to do what we do? Right? It doesn’t make sense. No, no. And I, you know, and maybe, maybe part of this is also on us that we should be putting pressure on our associations, that, that if they’re putting a conference on, there’s individuals there who maybe every individual presenting is from out of province or out of state, or maybe, you know, half of the people presenting aren’t massage therapists, that we should be putting pressure on our associations and saying, no, stop doing that. But like, you know, and probably the biggest way to do that is by not buying tickets to a conference. But I mean, I think they usually sell out because people are getting credits and things like that, which will be interesting when we see the credit criteria change next year. But, you know, maybe the, the dollar sign is the biggest way to put pressure on them. Or maybe it’s emails and phone calls to be like, you know, we have great people who can present on this and this and this, who work within the province, why aren’t those are the ones that you’re that you’re bringing up? Or within the state or, you know, wherever, wherever it is that you live?

Eric Purves 27:46
I yeah, I think the I like we said there were the dollars and cents the money talks. Yeah. And I don’t know what membership is like another profession or another member or another. Professional associations, sorry. But I would say if your numbers are going down, or your percentages are going down, your association start to look and see why. Maybe we’re not delivering what the members want, and they’re going to put their money elsewhere. If you’re getting more a higher percentage of your of the profession is deciding to become a member, then I think that says that they’re doing good things. So when they start going down, we start looking at why is that?

Jamie Johnston 28:30
Yeah. Yeah. And like I said, I don’t know how it works with the am ta down on the states. I don’t know if like, you have to be a member with them in order to maintain your license. Or if they’re an optional one, like associations are

Eric Purves 28:46
here. I think they are I just pulled up their website here and just looking to see this because they just had their their national convention just a couple days ago in Cleveland. Of all places.

Jamie Johnston 28:57
Yeah, I think, Justin, Justin Kobe Solace, I think winter that you and I were messaging the other day and mentioned that it was a

Eric Purves 29:04
good conference. Yeah, he sent me some some messages with them out in the night in the town, some pictures, and then some other people that we know, haven’t having a good time. So yeah, just looking at that there is the the mission statement of the MTA is to is to serve a MTA members while advancing the art science and practice of massage therapy. I think that sounds almost identical to the RM TBCs one and probably very similar to Ontario’s it looks like they’re they’re a nonprofit association for massage therapy profession. So that yeah, they’re just they’re not mandatory. They’re just because I think

Jamie Johnston 29:39
I think they have a different chapter in every state. It’s not like it’s not like the US AMT. Like that covers everything. I think it’s different by state. But I think they also have different regulations by state.

Eric Purves 29:52
Yeah, we’re just we’re just throwing out things right now.

Jamie Johnston 29:56
This is my understanding. It doesn’t mean it’s right. Yeah.

Eric Purves 29:59
So by Just looking at their conference, though, again, just quickly looking through who who’s presenting and what it what are they presenting on? It looks like it is almost just bread, a brief introduction, it does look like it is predominantly massage therapy focused. Now, when we look at this, though we can, you know, without critiquing the evidence or the or the topics, because that’s, you know, for a different podcast, because that would go on forever. It is still it is still all looks like it is RMT. Focused. Good. Yeah. Which is good, which also goes to another Association, which I’m just gonna clear my screens here is I looked through this is in Manitoba, right. So they are starting to lease I’ve started taking notice with the work that they’re doing, they’re starting to do some some great work there in terms of getting trying to promote and build up evidence based educators and conferences and, and their conference they recently had in this ring, which was another one that I was I was fortunate enough to present that I didn’t, but I was out of town busy doing stuff. And just was able to present and I didn’t get a chance to observe any other presentations that were there. But afterwards, looking back and seeing who was presenting and the topics they were presenting on. There was all RMTS as well. Nice. So empty, focused,

Jamie Johnston 31:35
just quickly looking at it, too. It looks like they’re their keynote speaker was Michael Phelps. And that, to me, that’s really cool, because that’s somebody who, I don’t know how many gold medals I got ones, but I think it was like a dozen or something like that. Who obviously would have used massage therapy. And for somebody who works in high-level sport, like every athlete wants a massage after they’re done training, right. So I think that’s invaluable to have a guy like that come in and be like, what you guys are doing is great. You know what I you know, I used you regularly as a as a Olympic level athlete. So I think it’s really cool that they bring him in and convince him to come in and be a keynote speaker for them.

Eric Purves 32:18
Yeah, that’s great. Yeah, I didn’t know that. That’s pretty cool. Yeah. Well, what BC? What’s that? They’re talking about BCRMT. Their conference coming up too?

Jamie Johnston 32:34
Sure. I’ll say that I’m not as big a fan.

Eric Purves 32:39
Yeah, I’m a little bit disappointed with with the direction that this conference has gone.

Jamie Johnston 32:47
Yeah. It’s. Yeah, it’s not as massage therapist presenter-focused, as I would like to see. And I don’t know that it ever has been. Even though like, last year that, you know, there was Sandy Hilton and Walt Fritz and Cory Blick and staff and some great presenters that were there. And you know, and then the year they brought Lorimer Moseley out, like, granted, that’s, that’s a case where you’re learning from somebody who’s not a massage therapist, but when you’ve got one of the leading pain researchers in the world to come out, that’s a phenomenal way to spend a conference, I think,

Eric Purves 33:24
for sure, but really important information. Yeah.

Jamie Johnston 33:27
But looking, you know, when you’ve got when you have very capable people within your association, that could be presenting and you’re not using them? I think that’s, I think that’s a mistake.

Eric Purves 33:41
Yeah, and what I’m curious about, and I agree, and I think what I’m, what I am curious about, though, is that there’s so bomb teen BC RMTS. Yeah, I mean, it’s kind of ingrained into us is that like, you know, we’re kind of the lead, we’re told, like, we’re the leaders in the profession. And we are, our education is great. And, you know, we’re doing those wonderful things. And for years and years and years, I think the association has done a really good job at hosting good conferences with good presenters and you know, like, those examples are used, but they have not been predominantly be see RMT focused in terms of who’s presenting, whereas other profession, other associations. You know, maybe some of the content isn’t as good in terms of the topics. But you’re still promoting RMT is with in that association. And when we look at this one here, you got your first three people I see on the presenter list are lmts. So they’re American trained, and educated.

Jamie Johnston 34:48
Not that there’s anything wrong with that. But you’re not within the profession. You’re not promoting from within.

Eric Purves 34:54
Yeah. And then you’ve got a professor UBC. Okay. And then you’ve got a physiotherapist. right from BC, Neil Pearson, okay, I’ve seen you speak, he’s got good information, but he’s not an RMT. And then you’ve got Aaron. And then you’ve got a panel speaker, which are all RMTS. So of all of the kind of presenters, you have one person that is a BC RMT. And then you’ve got a panel discussion, which is BCR. Empty. So it’s a very, very small segment of the day. And I find that just unfortunate when there is when you look at some of these other conferences, where you have BC RMTS presenting on their stuff, yeah, two different associations. But our own Association isn’t isn’t using the same people isn’t using the same people or when there’s tons here? And we know that and, yeah, it’s unfortunate. Yeah.

Jamie Johnston 35:47
Yeah. I mean, I could probably name 10 people off the top of my head, that would be great people to have present at a conference like this, like that, that aren’t used. And I know that those people are members in that association. So I, I’m not sure where, where the disconnect is, like, I don’t I don’t know who decides who’s presenting.

Eric Purves 36:11
Even when board members, we had no idea how that Yeah, that’s fine.

Jamie Johnston 36:16
But it’s disappointing because I just think there’s so much more that can be done to promote from within. Where, and if I think that’s one of the important things to talk about is if you did promote from within think about how much more you could do for the profession, and for your association. So let’s just give an example. I’m putting together a course with Megan Mounce on how to help people who have had mastectomy and have dealt with breast cancer and how to use movement and things like that. So you’ve got, you’ve got this individual who has a Bachelor’s degree, who’s an RMT, who’s a personal trainer, who has real life experience, going through something like that. And yet, you’re not utilizing that person to talk about that, and then being able to utilize a person like that. For other people who were there were that’s their interest, where you can almost hire them and be like, we want you to be like a mentor to other people who want to do the same thing. Yeah, right. If we promoted from within more, there’s just so much more we could do.

Eric Purves 37:32
Yeah, that’s it. I think it’s such a great point, it makes so much sense when we look at it that way that you could write like Sophie. So using Megan’s because we know Megan, and I’m sure of the content you guys are going to put out is is is fantastic. You know, and that’s a big thing now, too, is the the, like cancer recovery, oncology or breast cancer, right? You have a real world experience as somebody who’s had two bouts of cancer, or Anyway, she’s recovered from breast cancer. And has been through that process. And as well as she’s, you know, she has all these other personal life experiences. She’s really well educated on the topic. Like she would be somebody that’d be fantastic, too. Yeah. And so, no, or, you know, can we blame the arm TBC for not asking or they might not know, but they may all but they also don’t have like these other associations. They don’t have. They don’t request they don’t put requests out there. No. Right to like, they don’t they know, there’s nothing that we ever received. I’ve never signed anything like, Hey, you want to present? You know, we’re doing a thing on rehabilitation? And, you know, we’ve helped pay for your education. So, you know, why don’t? Why don’t you come present? Or, you know, or like, they’re like, Oh, hey, you know, we were looking for for people. You know, I’m sure if they have a team of people they find to look for, why don’t you if you’re doing a thing on rehabilitation? Why don’t you ask like, why don’t you put a thing out there and be like, Hey, we’re looking, we want to include something on breast cancer. And I see they do have a talk here on it. But maybe you have a couple different presenters on that topic. Right, rather than just one, and then all these other things that doesn’t really tie together? No, like, I don’t know, for somebody that if I was organizing a conference, it would, they would have more of a theme of rehabilitation is so vague. Yeah.

Jamie Johnston 39:23
Because it can be any 10 different directions. Like, like, I think tobacco point you said was a couple years ago, they did that oncology conference where they brought the folks up from here well to present which they did a great job presenting, but then if you can have somebody like Megan and somebody else with some experience there to present at that same conference, you know, and you’ve got a you’re talking about a certain population and you’re talking about, okay, how you how can you do rehab with that population or, you know, how can you support their support network, how can you do, you know, five other things with that population of people. So, So maybe it’s more important to this has gone off on another rant, but to make the conferences more about a population, and things within that population of how you can do things to help them.

Eric Purves 40:10
For sure. i That’s such a great point too, because the conference is should be focused on on something specific, I believe it should be based on, you know, the this conference is going to be on oncology, which they did, but then there was something there that wasn’t on Oncology at all. Yeah, you know, or there’s wine like they didn’t want on aging. And there was some stuff there that wasn’t aging, but some stuff that wasn’t and this one’s on rehabilitation. But what is rehabilitation? Like? It’s such a broad thing, like, they got stuff here on, they have a one on pain science and rehabilitation. Okay. It’s one thing, which is important. One on multidisciplinary, you know, you got the breast cancer one. But then you got like this other one on tendinopathy. So it’s, it’s it’s all over the place. I just find that it doesn’t it’s not cohesive at all.

Jamie Johnston 41:10
Yeah. Yeah. That I mean, we pump it up all the time, because we always talk about San Diego paints on it. And granted, every everything that’s presented down there might have a different angle to it. But it always comes back to talking about pain and helping people in pain. Yeah. Right. Whereas like, yeah, rehab, I mean, great, great topic for a conference, but it could be, you know, rehab with athletes. It could be rehab with MBA people, it can be in rehab in the workplace. It could be, there’s so many ways you could go with it. Yeah. Which would be maybe we should put a conference on?

Eric Purves 41:45
I think so I think we do. I think you’d do great job. It’d be Yeah, because it’d be cohesive, because there’s a whole bunch of stuff in here that has nothing to do with the topic of rehab. Yeah. You know, it’s weird. It’s a bit of a disconnect. And for anybody that’s has any experience in kind of marketing or sales, if there’s a disconnect between the message and the content, it people are become unsure of what is they’re getting? You know, I would imagine that some sort of, you know, I guess we’re being probably overly critical here. And, you know, we’re not trying to be critical of the association’s saying how we think this, these, this conference could be done better. Yeah. And how some other ones seem to be better with getting back into focus of r&d, led education. Is that okay, yeah, this conference sold out. But did it sell out because of the content? Or did it sell out? Because it’s because of credits? And that might be I think we already had a conversation with that about getting rid of the credits and how that impact? Yeah. Fashion. I’d be very curious to see if this type of President or this type of conference still sells out? I don’t know.

Jamie Johnston 42:59
Yeah. Well, it’s interesting, because the rmta will rmta Oh, one is a virtual conference. But they, they don’t have credits anymore. So I don’t know what the what the take up is on their conference, like how many people they’ve had registered. But, but obviously, they wouldn’t do it if conferences didn’t work. Yeah. Right. So hopefully, because of the way they’re doing it, hopefully there’s uptake because RMTS shouldn’t be learning from r&d.

Eric Purves 43:29
Yeah. There was a conference a couple years ago, on May, I think it was during the COVID. year, maybe just before just before. During COVID, there was a conference, an online conference that several people in Ontario did, and it was for charity. But they had hundreds of people, but it was all RMTS presenting. Perfect. And it was like it was cheaper. Like, oh, it’s like 50 bucks. I think all the money went to charity. And none of the presenter has got a penny. But it was great. A great conference and extending it was all warranty. focused and really well attended. And I thought it was a great idea. I think it’s a great idea. So it isn’t being done out there. It’s just doesn’t seem to be focused here where we live.

Jamie Johnston 44:14
Yeah. Well, maybe we’ll have to change that. And but

Eric Purves 44:18
yeah, you know, yeah. Could be could be. Anyway. So RMTS leading r&d is what we’re looking for, is we’re advocating for, you know, sounds like we whine and complain a lot, but I think it’s just because we want better.

Jamie Johnston 44:29
Yeah, it’s, I mean, literally, every the whole reason that we even have this podcast is just to build the profession up. It’s not about trying to complain about other people and what they’re doing, even though it probably sounds like that sometimes, but But really, we would just want the profession to move forward and we want the people in the progression to move forward. You know, we need more people to be presenters. We need more people to share their knowledge and share those things that they’re interested in so that we all get better Look, I know you and I have had conversations before, and I’m like, I will forever be the team guy. And I think the bigger team that we can make of presenters within this profession that are presenting evidence based information. Yeah. And you make that team bigger and bigger and bigger all the time, it’s only going to help

Eric Purves 45:18
you because everybody’s gonna build up everybody else. Right? Yeah. It just makes sense. Yeah. And, you know, it’s, and for someone like myself, who’s I presented it? I don’t know. 10 different conferences, maybe over the over the years. And with all the courses and lectures and stuff, what you do see when you have RMTS, presenting and leading as you do, and I’ve had people, many people reach out to me, like, Oh, I saw your presentation, or I saw your webinar, or I was I was, you know, I was sitting in the front row and asked all the questions, I’ve been really empowered to, to start to wanting to teach her to lecture or to research or whatever it is that they’re interested in. And I’ve since seen many of those people over the years that have that have that have said, hey, look, thank you. Yeah, they are now presenting. Yeah, great. And so if you’re going to help one person, and then that person gets up there, and then they inspire somebody else. And my inspiration for starting to wanting to teach and wanting to present. And all the things that I do now was from that first and you go paint Summit, where I saw all these people talking about stuff they were passionate about knowledgeable about America thinking, I want to do that one day. I don’t know if necessary want to present San Diego because I think that would stress me out too much. Because I like to go there for a good time not for just to enjoy a holiday and enjoy holiday doing some stuff here for a conference. But anyway, I was really inspired by that. And I and I would not be doing what I’m doing now if I didn’t attend that conference. So it’s really, really important. The association’s to realize the power that has great power become comes great responsibility.

Jamie Johnston 46:58
100%. Yeah. And with the amount of members that most of the associations have. They need to look at that responsibility very seriously and take it seriously and build up the people in the profession. I think that’s a great way to end this podcast

Eric Purves 47:16
yesterday and my friend.

Jamie Johnston 47:19
All right, everybody. We’ll see you next time. We hope you enjoyed this podcast. These kinds of topics are what we’re all about. If you’d like to learn more, go to our websites,

Eric Purves 47:31
themtdc.com or ericpurvescom. If you know of any other therapists that could benefit from this, please tell them to subscribe

Transcribed by https://otter.ai

Podcast Episode #26 The Biopsychosocial 40 Years Later


Jamie Johnston 0:12
You’re listening to the massage therapist Development Initiative. I’m Jamie Johnston. And I’m Eric Purvis. This is a podcast by massage therapists for massage therapists. Our objective is to simplify how to be a more evidence informed practitioner. Let’s dig into this episode.

As somebody who just turned 47 years old, I can’t quite remember things that happened 40 years ago, but the biopsychosocial model of pain has been around for about 40 years now. And it’s very important for us to take a look at anything like this and understand what changes have taken place in 40 years. And how have we improved?

Eric Purves 0:57
And this is a this is actually a really kind of Hot Topic, really the the bio, psychosocial, social model and, you know, is it like, how do you apply it in practice, you know, and there’s a lot of arguments back and forth about like, you know, it’s on a predictable model, right? It’s not like a mathematical model. It’s, it’s a conceptual framework and the authors of this paper, this paper is called the biopsychosocial, social model of pain. 40 years on time for reappraisal, it’s in a relatively recent journal of pain. And, yeah, it’s good because I think it it challenges or brings into discussion, a lot of the points that you hear, especially those of us that spend time reading the debates on social media, and a lot of problems people see in the bio, psycho social. And I what I feel is that in, in my experience, my understanding is, the bio psycho social model is itself not much of a problem, because it just it seems, has been around right for over 40 years, in the pain world longer. I think it first was talked about 1947 or 1977, I think, by George angle, and then, you know, loeser or loeser, have you printed him and Waddell had it? You know, and, you know, fears after that. But the facility is still around, I think there’s there’s still a lot of value. But the biggest problem seems to be is how was it used in clinic? Or how was it researched? And then that’s what we’ll talk about today is in this, this research paper, or this discussion paper, they talk about how when people use the terms biopsychosocial oftentimes, the studies are just looking at one aspect of it. They’re not well defining other like, well define the psychosocial or what is social? Or what is conservative psychological. And, you know, in the bio, like when we’re looking at bio, what, like what’s included in that. So there seems to be lots of a gray area there. And I think that’s probably when people are critiquing the model. And I think they do have reason to critique it. It’s because more often of how the model is applied, rather than the muscle word to use the conceptual, conceptual framework of what the model is supposed to represent, which is this full person care.

Jamie Johnston 3:14
Yeah, and one of the things that really stood out, as I read through it is how much they touched on multidisciplinary care, where they had psychologists that are dealing with the psychological end of it and physios that are maybe handling the bio, and you know, and then the social factors that come into play, and the importance of communication between all parties, when they’re trying to help that person and, and interesting, I’m sure we’ll get into it when we’re looking at the the social aspects of the person returning to work, the importance of communication with the workplace, from the people who are delivering care so that it’s more of a, it’s more of a person centered approach, when you’re trying to help that person get back to their job or get back to those things that they enjoy doing.

Eric Purves 3:59
What I found funny with this, though, when you think about it, you know, you think about medicine, and you think about musculoskeletal care and MSK pain and, and whatnot. And you look at this, this model has been used for pain for 40 years, or it’s been talked about for 40 years. And the reasons that they say here was Waddell and Loeser. They observed that many of their patients with low back pain didn’t improve after corrective surgery. So the pain cannot be attributed to only biological influences. It’s funny though, cuz it makes you think what happened to all the years before that when people didn’t get better? You know, it’s funny how like, it took that long for people to actually start wondering if there’s something else going on. Yeah. And excited. Seems like, that’s like, seems to make sense, but it’s funny to think of how people must have thought about the body and pain.

Jamie Johnston 4:54
Yeah, and really interesting that those two, those two people that you mentioned was with Wadell and Loeser. You I would almost say that they were surgeons.

Because I wouldn’t have thought that that was coming from surgeon because we, I mean, we say it tongue in cheek a little bit and maybe make fun a little bit that we’re like, oh, you’ve, if you’re a scalpel, you just want to cut everything. Yeah, right. So great to see that they that it was surgeons who were looking at, hey, maybe we need to change the way that we’re doing things. And also really interesting that, you know, that happened 40 years ago. And maybe it’s just because you and I haven’t been therapists for 40 years, obviously. But we’ve only really seen it catch on and become more of more of a thing when we’re helping people in the last 10 years. Yeah, I would say model.

Eric Purves 5:43
Yeah, yeah. Oh, for sure. And even if I think you know, back to when I first started diving into the stuff and trying to understand it, and think I did my first CE course teaching in 2015. And I remember just kind of bringing these very basic ideas, because I was only still learning to two courses to try to be like, hey, there’s some interesting stuff that’s out there, maybe, you know, like, let’s, let’s talk about this. And then that was kind of the general idea of those early course stakes. Nobody, nobody knew about a psychosocial as then. Yeah. So it’s been around for 30 years. Yeah. And so nobody knew. And I was only had just been I’d heard of it before, but I didn’t really pay attention to it. Like, I didn’t really mean much to me. I was like, oh, yeah, okay, whatever. But it’s interesting to to, to see like those early days. And we know from our experiences, when we searched for spare teaching together in 2018, we started talking about things and bring up the biopsychosocial. And little bit of myth busting in there and some of the science of pain stuff, and how that stuff was completely new. To like, 99% of the people, whereas now, obviously, the last three or four years or two or three years, particularly. It’s everyone’s, yeah, it’s a common term. And people can have a general idea of Oh, biopsychosocial, yep. That’s like treating the whole person like person centered care. You know, what that exactly means? How do you do that in practice is still that’s the difficult thing. But that’s what we call our practice. Not a perfect. Right is to that’s the hard part, but at least people become more aware of it. But yeah, it’s taken 40 years. Yeah. It isn’t our profession where we are in our part of the world. Yeah.

Jamie Johnston 7:21
But then you look at, like the Louis Giffords that we’re doing this ages ago. Right. So like you said, it might be that it’s our profession or part of the world. Because I think Louie was a UK guy. He was yeah, nice, 80s and 90s. So maybe that was more prevalent there than then it was here. We don’t know.

Eric Purves 7:42
And this without going on too much of a tangent, which we might want to and we’ll see what happens here is the is when we look at the stakeholders involved in our profession, at least here in BC, right, we got the association, we’ve got the college, the cmtbc. And we’ve got all the all the schools that and there’s now 10 of them, maybe I think it was probably about 2014 2015 around there. If you tried to teach a Con Ed course, that said, and I said had bio psychosocial and you would not they would not approve it is out of scope. With the argument being that they hadn’t really the idea was they had no idea. They had no idea what it meant. Our own regulatory body had no idea what it meant. And even you know, our association in the schools and stuff still don’t adequately teach that stuff like the association. You know, they have conferences, and they put out content out there, but I don’t ever see anything on there being I think what biopsychosocial Yep. And you know, the it but it however, in Ontario, they put out some really good stuff. You had some great stuff there too. And so if we want to compare ourselves right to to another province has been around for a very long time and Ontario regulated province, is what I meant to say if I didn’t say that, there’s no province has been around for a very long time. So I’m tired back from the gym, my brain still foggy. The they had a conference in 2019, which I was fortunate enough to be at. That was I think it was called like bio psychosocial care or something for RMTS or something. So they actually had a conference those three years ago now. And they’ve had other things subsequently, which have been been kind of trying to bring us this idea to to the professional to the members. So we don’t have that here. And I really wish you know, this is a call to action thing. I wish the schools known I know some schools are great. I’ve talked to some the the people that are clinic directors and stuff of schools here and they are trying to do it but it’s just not widely accepted and just not widely accepted or maybe understood. And so I would suggest anybody that’s curious about what biopsychosocial means this is this is actually a pretty good paper to start at.

Jamie Johnston 10:04
Yeah, yeah. Well, and it’s it’s very cool that there was a lot of things in here as I read through that resonated with me because of my, because of my background. And also, because I’m somebody who works at a job in industry where people get hurt. So a lot of this really stood out to me. And it’s funny, one of the guys at work, told me he’s like, why don’t you go to the chief and see if you can come in once a week? And just do what you do with guys here who who need the help, but I think there would be a big conflict of interest. If I did that. If I, you know, if I was working on guys, and WCB was like, well, you’re one of his co workers, you can I think there would be too much of a conflict of interest for me to do that. But it would be very, yeah. Yeah.

Eric Purves 10:48
And that would be really cool, actually. Because that way, you would have the social and the bio, and the psycho all together in the workplace, in with their colleagues and their, their social network. And then yeah, you became the new exercising, which would be bio and Psycho and social would be the whole thing, right, are getting moving. And we’re going to be doing any hands on stuff. I mean, that’d be brilliant idea.

Jamie Johnston 11:12
I think so. And I’d love to just take a portable table and and be able to set up the table in the gym and be able to go through rehab with guys and do some treatment. And like I mean, guys are coming to me all the time anyway. And being like, Hey, this is sore. What should I do? So yeah, it’d be cool to just have like, you know, a day of clinic hours at the fire hall. So that somebody who needs it could come in and, and get what they need. But, but I think the problem is once WCB or something like that was involved, they’d be looking and going, No, you can’t have one of his co workers doing the work, because we’re not going to get an honest feedback about what’s going on with him. I think I think there would be too much of a conflict of interest score. Yeah. Yeah, that would be really cool. Yeah, very cool. Yeah. So just quickly skimming through, of course, we talk about psychological treatments, when we’re talking about the bio psychosocial and quite often, quite often, we’re looking at things like mood disturbance, and high levels of unhelpful thoughts like catastrophization, you know, the person kind of thinking that they’re broken, and lowered self efficacy. So when they talked about it throughout the paper, that’s a lot of the things that they talked about. And that was, were they, in my understanding it anyways, as I read through the paper, that those things were better handled by, say, a psychologist or a mental health expert, to be able to help them through that as part of that multidisciplinary care that we talked about a little bit at the beginning.

Eric Purves 12:36
Yeah, this paper, what I thought was really interesting was they broke down, like they broke it down into that, like a psycho bio social, and looked at the research. Because I think it’s just really important, you know, that the common term, you know, if you’re a hammer, you see nails, right. And if you’re a psychologist, and you’re treating people with that are hurting, of course, you’re going to be viewing them through a psychological lens, of course, your interventions are going to be more on the psychological end of things, right? Just like when we, as massage therapists, were treating people we’re going to we should be aware of the psychological and social stuff. But really, I mean, we’re working primarily on bio things. We’ve meant in touch and exercise, you know, a little bit of education, but most of our more focuses in the bio like so. It’s I liked that they they broke it down into this and talked about, like, what was included in psychological research, and what was included in bio was good in the social stuff. But what I thought was really interesting, though, was like the little quote here says that, you know, there is positive effects is positive outcome seen with the psychological interventions to focus on the things you said thought processes, beliefs, behaviors, this type of thing that says that the size of these effects have generally been found to be a small or moderate, and systematic reviews of randomized controlled trials with chronic pain samples. So with this, I mean, go shows is that, and I think if you look at all the research, they’ve probably I think they quote this all and throughout this paper, is that it doesn’t really seem to matter what you do. When you look at the literature, the outcomes are all relatively small to moderate at best. Yeah. So what that can sound to some people defeat us, to me that sounds Oh, that’s actually sounds pretty good. Because if you’re doing something done, or you’re doing something, you’re seeking care and someone is providing care to you, chances are you’re probably going to feel better than not. So doing something is like this is good. And that lets us know that there’s not like a right or wrong but they do say in here, though, is it’s not necessarily providing a specific treatment. It’s finding the treatment that works for that person. Right. So it’s not like you need this. It’s like what’s going to work for this person, this presentation here today. I like that rather than you step was the person need rather than what are we going to do to the person?

Jamie Johnston 15:04
Yeah. Interesting as we go through like, there’s a couple things that stand out to me is when they’re talking about the psycho psychological treatments, they mentioned how there hasn’t been a lot of research about involving the the person’s family, but one place that they did look at. And I would like to know if this was any of Melanie wells research with stuff that she does with kids. But it showed that the more that the parents are involved in, in helping the kids, it can actually have a positive effect on the parent and the parent experience. So when you’re when you’re teaching, how do they say they’re teaching kids and adolescents, about different strategies that they could use, whether it’s communication or how they handle things at school, and the more that the parents involved, it can actually have a positive effect on the pain experience that a parent feels? Yeah, unreal. Is that great stuff.

Eric Purves 15:58
And there’s nothing that I thought was really interesting wasn’t like, you’re talking about how, yeah, when the way kids are treated with that, with chronic pain is very different from adults are treated with chronic pain. Because in adults, it’s like the individual is being but is being treated, whereas kids, they involve the whole kind of their social narrative family, which is, I mean, just makes it makes sense. But it’s just funny how you’re like, Oh, you’re no longer a child, you’re now an adult. So therefore, we’re just screw up family. Like, we’re all gonna involve you. Right? That’s not necessarily included. But I guess it does make sense though, because the kids need to be cared for. And so the parents have to be involved in care as an adult, you’re independent, least in our most of our cultures out so we distance ourselves from our family a little bit. Yep.

Jamie Johnston 16:45
Yeah, or different circumstances. I mean, you look at me 47, single, no family in town. So the experience that I would go through if I was experiencing pain is a lot different than, say, somebody who has a family at home that they come home to, right. And if the kids were dealing with something, then the parents dealing with that is going to have more of that connection, feeling between the family and probably better care and all those things, especially if, say, the doctor or the physiotherapist is in really good, or having good communication with the family, about me, and education and all those things, then it’s it’s a more cooperative experience. Yeah, yeah. Oh, yeah.

Eric Purves 17:25
Which would be more biopsychosocial that would actually be a better application of the model, right, involving everything. Yeah.

Jamie Johnston 17:34
So they, I mean, they went into, and they talked about a lot of the biological stuff, and separating that into different categories, about how people are experiencing pain, and you know, whether it’s peripheral or central mechanisms, inflammatory pain, chronic pain, and all those kinds of things. And then talked about the treatments that they can use for those things. And what I found very interesting is that when they started talking about exercise, because exercise, obviously, I’m a big fan of that. But when they talked about the exercise, they were they were talking about usually exercises is driven towards building muscle or loading the joints and doing these other things. Whereas they found or my understanding is they found if you geared the exercise more towards just what they were doing at work, or or their chosen activity, and getting them back to doing that thing, then they had more success.

Eric Purves 18:30
Which makes sense, because it’s that your your task or your goal, your functional desire, whatever it is, it’s tailored towards that specifically. Yeah. Makes sense. Yeah. Well, I thought it was interesting that they it says exercises, you know, it’s considered they consider that bio, but I think it’s almost, I mean, obviously, there’s bio going on there, but I would say, Well, yeah, like, it can’t just be bio because you’re not, you know, there’s going to be psychological and probably social unless you’re like in your garage by yourself. Okay. There’s, there’s not like a social influence ever. There’s a psychological influence, like exercises, if something of value something you enjoy doing that it’s not just gonna be bio, so I think that was fine when they said it’s exercise is considered a bio intervention. We’re like, well, it’s I think it probably includes the whole bio psychosocial.

Jamie Johnston 19:23
Yeah, yeah. And I think that’s, I’m trying to remember who the presenter was in San Diego this year when he, he stood up and he said, Okay, who wants to go home and do some homework tonight? And then he’s like, Yeah, neither do your patients. So stop giving them homework, stop giving them exercises to do.I forgot what that yeah, that was great. Great, which was brilliant. Because they and I think that’s whereand, you know, I was on a podcast a little while ago with some some of our friends down in the US and when I was talking about therapeutic exercise, and they’re saying it’s not in our scope. I’m like, well, movement is so I think we have to Start also approaching this and being like, well, let’s stop talking, let’s stop calling an exercise. Let’s just call it movement. And let’s just talk about what meaningful movement is for this person. And how do we get them back to that meaningful movement. And that meaningful movement might be a specific task that they do at their job that they can’t do right now. So how do we, how do we change that task? Or how do we make it so they can do that task? So it becomes more meaningful, and they feel more fulfilled? At their job, or whatever the recreation thing? Is that, that they’re trying to get back to doing

Eric Purves 20:32
that’s a weird thing. Hey, still movement is allowed. But exercise, isn’t? We?

Jamie Johnston 20:38
Yeah, well, it’s funny. How do they define exercise? Well, so my understanding of it, because when I was on the podcasters, two folks from the US, and I said, but you guys can do active range of motion and passive range of motion and a treatment under like, Yeah, that’s fine. Like, so why can’t you do movement? They’re like, it’s that we can’t prescribe exercise for them to do at home. I’m like, But what about if your prescription was gonna work in the garden for half an hour? They’re like, yeah, we can do that. I’m like, so just prescribe movement. And, yeah, that’s, what about if it’s get on the ground and play with your kids? Yeah. What if it’s, you know, so let’s, let’s change, let’s change the opinion around those things. And I think a lot of times, we’re also really, really scared that we’re going outside our scope. And we might get disciplined for going outside of our scope. You know, and then as soon as it’s got the word, in this case, as soon as it has the word exercise attached to it, they people automatically say, Oh, well, that’s out of scope. But if we say it’s movement, there’s no reason that can’t be in your scope.

Eric Purves 21:46
Yeah, just move lots. That’s your that’s your prescription. And that’s exercise.

Jamie Johnston 21:51
Yeah, there’s no reason you want to do you know, somebody comes in and they’ve got a shoulder issue, there’s no reason you can’t grab their arm and passively move their shoulder and get it into different ranges, or do some adaptive movements with them, you’re not prescribing an exercise for them to take home, you’re not prescribing something, you’re, you’re just helping them get back to doing the movements that they enjoy or that are meaningful to them. So and to me, it makes more of a psychosocial. Not psychosocial sense. But it makes more sense to me to, to talk about rather than us giving a treatment or delivering a treatment. We’re engaging in treatment with our people. Yeah. Because we’re, we’re engaging and educating and conversing and finding out what’s important to people, rather than us just saying, okay, get on the table, and I’m going to do this to you.

Eric Purves 22:40
Yeah, yeah, sure. Yeah, I 100% agree, that’s such a great point to make, right? You’re engaging with with the treatments, you’re not just doing it, you’re not doing something to them. Now, some of them is great. Like, I mean, I mean, sometimes when I go, if I go for a massage, I often want something done to me, because I don’t necessarily have something wrong that is bugging me. It’s just like, I want to feel good. That’s different. Right? There’s the field, I think, is a seven point distinction to make is that, yeah, you can go and get the table and just someone just like spoil yourself. That’s fantastic. But if it’s like, if it’s something that you’re suffering with, it’s bugging you for a long time. And, you know, that passive approach isn’t working. Yeah, try and engage a bit more with with your clientele.

Jamie Johnston 23:18
Yeah. Like, well, like we’ve talked about so many times before, too, you know, we were fortunate here, because we have so many people that have unlimited benefits that, that maybe they come in once a week, but that’s just an hour break from life that they get, which is good. And there’s no reason you can’t just do a passive relaxation massage. Maybe I shouldn’t say that a relaxation, massages password, because you’re still having an influence. But you know, in those cases, there’s no reason but somebody comes in and they’re like, I’m having a hard time moving my shoulder, or moving my hip or my knee or whatever, then, you know, we want to, we want to engage more with them and figure out how we can get them back to doing the moving that shoulder or so that they can do the things important to them. Yeah, yeah.

Eric Purves 24:00
I agree. I love that term, engaging in treatment, rather than just doing something, doing a tree gauging your dramatic that’s, that’s a very important distinction to make. So hopefully, I’ll catch on. I hope you should do like a social media campaign hashtag engaging in treatment or something.

Jamie Johnston 24:15
Yeah, yeah. Well, I’m working on some stuff now, but doing some thought reversals and things about that to cool. Medicine, but but we’ll see. We’ll see if anybody wants to listen to me now.

Eric Purves 24:28
Yeah, well, some people listen, some people listen this podcast so enough to keep it keep us keep doing them. So there we go.

Yeah. What it was, it’s just kind of keep talking about this, the biotherapy about it and just kind of expanding on the bio to like expand into the bio psychosocial. And this is a there’s gonna be a bias statement here, but it’s okay. It’s our podcast. I just I just think it’s really important for us to emphasize that. Even though we are engaged, we are educated in a bio dominant biomedical We’ll thing and we are hands on therapy is mostly, mostly by Oh, there is always going to be psychosocial stuff, right? With moving exercise coming for treatment, there’s an interaction between two people that’s social, right and psychological. So it’s just that we are, regardless of what you think of the biopsychosocial. Every aspect of a human is being engaged with during a during a treatment. And this was the thing is, though I find interesting is I find it very difficult to understand how any other MSK profession other than massage therapists and physical therapists are able to actually provide a full BPS experience in their treatment. Like if you’re coming in and say it’s chiropractic, and it’s like five minutes and just getting adjusted and gone. Is that biopsychosocial? Like, can you actually apply all the kind of aspects of this? I don’t know, I would say that I think what we have as physios is we have time. Some points are short, but I would say on average, they’re, you know, 30 to 45 minutes long. Least we are.

Jamie Johnston 26:09
And I think that, in fairness, some chiropractic appointments are as well, depending on the look.

Eric Purves 26:16
Yeah, yeah, I am not saying all I’m just saying, like, if you look in general, the two professions that are set up to be able to really do this properly with the problem if we have proper education or proper understanding, I think we we should, you know, chiropractors only are listening to this podcast anyway. But massage therapists, you know, I think we really are set up to do this, because we have so much time with people, we can listen and validate. And we can educate, and we can rule out red flags. And we can reassure when, if it’s, you know, there’s nothing nasty going on, and we can revive touch, soothing, safe, comfortable environment, and educate and engage with people to do the things that are important to them. And that’s something you can’t do in 10 minutes. 15 minutes. No, I and some people I mean, I’m sure somebody’s gonna bother, you can you’re full of shit. Okay, maybe. But I would say that’s, I’m not convinced. No, no, anytime you do this. And so when you’re looking at just quick, quick, quick appointments, boom, boom, boom, those are bio nature, bio focused, you’re missing the bigger part of treating the person.

Jamie Johnston 26:40
And interesting, if you look at the psychosocial aspect of things, I don’t know, of any, or if there are any psychologists or counselors that offer a 15 minute treatment. They’re all 45 minutes or an hour. Exactly. Because they want to have a long discussion with people they want to, they want to have that chat, and they want to figure out what’s going on with them. So, you know, when we look at the other aspects, there’s very few that are that short of a treatment. Unless it’s maybe a quick check in about something. Right?

Eric Purves 27:57
Even medical doctors right like USC Medical Doctor for something like they they’re gonna rule then a like, Oh, you have psychosocial that might be that stuff happens. But they’re looking at the bio, they’re looking, what’s the disease? What’s the pathology? What can I rule out here? Right? So it’s when you read this stuff, and we can go and talk about, you know, the, you know, how this is often applied in these kind of interdisciplinary or multidisciplinary pain clinics. You know, those little requirements, we will have a long time, these are something you can’t just like, have, I don’t think you can have like a high volume, bio, psychosocial practice, and do really good work with engaging in small amount of time, a small amount of time, I think it’d be really hard. Yeah,

Jamie Johnston 28:40
I agree. So this, this is where I think we could get into it now is when we’re talking about, they’re talking about the social aspects. And they they talked a lot about the workplace, and people who are on a return to work program. And this is where it kind of hit home to me because of my past, being a first aid attendant in a, in a sawmill, and watching, you know, treating dealing with people who got injured, and then watching them deal with compensation and coming back to work. And they really focused on this about the importance of communication with the workplace, and how important that is for, you know, the person who’s trying to get back to their job, where the physiotherapist or the therapist who’s helping them should be in contact with the workplace, but then also in the workplace, that the supervisor should be trained in how to speak appropriately to the person who’s injured. And to me that just like that would be phenomenal compared to what I’ve seen in the past, because, from what I’ve seen in the past, companies would always be like, Oh, safety is our number one priority, until it cost $1 To change the safety program, and granted, you know, this is back in like 2006 Next one, I was doing this. So hopefully things have changed a lot since then. But the I just think it’s amazing that they looked at it and said, if you’re in communication with the workplace more, then you’ll have better outcomes for the person who’s trying to get back to work. Right? just phenomenal. And that’s where, like we talked a little bit before we came online. That’s where our friend Corey Blickenstaff who is a physio who works in a workplace, and helps people who are injured, like how, how that, like the outcomes that he must have, compared to somebody who was maybe off site. And I don’t know if there’s ever been a study done on it, but it must be amazing. And give the workers confidence that they’ve got somebody there, who’s there to help, should they get injured? So the social aspects of that must be phenomenal.

Eric Purves 30:50
Yeah, it makes sense to me, it just, I mean, okay. Sometimes things that make sense logically, aren’t always true. But, you know, using making an informed opinion, based on this, some this body of research, you know, if you had if, if a large enough workplace could afford it, and I’m places probably could write, you know, a large enough workplace could afford to have a physiotherapy physiotherapist, for example, on on staff or on a contract to come by? I mean, that would that would be such a benefit. And I bet you, I would be, I would love to see if that increased productivity, if that decreased, miss. Locks, work, you know, less work safe for workplace injuries, you know, I think that would be such a great thing. And there’s probably studies out there and for anybody has them, please send them our way. I just thought it would be that would be such a brilliant thing. And maybe some parts of the world they do it in. But if that’s I’ve never heard of that here in Canada. No. Having like an on site, or something that comes by once a week or whatever, or every two weeks to to treat staff.

Jamie Johnston 32:02
I’m actually starting to hear a bit more because I have a friend who is an athletic therapist. And I can’t remember the name of the company. But she had me come in to do some first aid stuff with the company. And she’s there as like, a director of like exercise and things. So they have an exercise room there for the employees where she can take them in. She has somebody who’s a massage therapist that comes in once a week. And she she organizes all of this for for everybody who works for that company. So it must be catching on a little bit. That to the point that she’s got a full time job doing this. Yeah. That’s brilliant. Yeah, great. Yeah. It’s very cool.

Eric Purves 32:37
Shouldn’t you think it’s such a hard worker, particularly in the the environment we’re in right now where it’s impossible to find workers like, like everyone, everyone’s hiring and you know, what a great perk it would be to if you’re like, hey, it comes with our workplace. We got you a massage and physiotherapy come in. It’s all included as part of your years. Part of working in package. Yeah, that’d be brilliant.

Jamie Johnston 32:59
Yeah, I’m sure it would be a draw. Yeah, huge. Bigger companies like Google in that have, like full time massage therapists to work there. And yeah, and things like that. So but I mean, that’s a multibillion dollar company. So you know, compared to smaller companies, that’s a lot tougher. But one of the things that I that I think is important to touch on that I would love to see is they didn’t, they didn’t talk in here about educating the workplace, about educating all of the other employees who aren’t injured.And I don’t mean that like when somebody’s injured, the rest of the people have to be educated about that person’s injury, it’s educating them about why Return to Work Program is important. Because like, for instance, when I worked at the mill, it was always if somebody was off injured, they’d come back to a place that’s, you know, full of bravado that guys are going, you’re just a wimp, you’re just trying to get a claim, or you’re an idiot, there’s no reason you weren’t hurt. And so when you look at that social aspect of it, that can be really detrimental for the person who’s trying to get back to work. So if they would be really interesting to see if there was a really good education program they could do in those places to be like, Hey, we know that we’re going to have better outcomes if this person isn’t made fun of if, you know, your opinions are kept to yourself, and we’re able to work through whatever the person’s injury is, and we’re here to support you as well. So that if you get hurt, we can take the same approach with you. And, you know, research has shown us we have better outcomes, and this is going to be better for your home life. It’s going to be better for when you have to pay the mortgage, and all those other things and explain to them, you know, the benefits of that? Because I think that would make a drastic improvement on those return to work programs withwith people coming in.

Eric Purves 34:51
I think that sounds like a brilliant idea. You just said. Education regardless, it seems like doesn’t matter what The topic is, you know, education often seems to be the answer. Yeah, you know, the more you understand what’s going on, the more accepting we are the better decisions we make about things, generally, right? These things all play a role. So, you know, why would that be any different in the workplace? I think it would just be a brilliant thing for it to educate the workers as well. What’s going on? And why it’s important? Yeah.

Jamie Johnston 35:24
Yeah, it would be cool. Maybe I shouldn’t approach the firewall a little bit and be like, hey, once a month, I could do like a safety education thing or something?

Eric Purves 35:31
You really should, I think you should see it just I think it’d be probably more rewarding as well as probably see, I would, I would be surprised if you didn’t see. Cause of benefits from that with your coworkers. Yeah, yeah.

Jamie Johnston 35:44
Cuz and it’s great, because we have a, like a light duty program, because we do our own dispatch. So if somebody is injured, we have it set up that they can actually just go and do dispatch, so they get to sit in the in the room, and they’re answering the phones and doing all that stuff. So they’re not out, you know, having to find a structure fire, but they still get an hour or two a day to go in the gym and do some movement. And you know, try to be healthy. So it’s, it’s a pretty good program. But there’s definitely improvements we can make.

Eric Purves 36:10
What it mean for meeting this paper here, too, it’s definitely in the workplace, engaging workplace is under utilize, you know, the one of the quotes here says, engaging with the workplace as part of the treatment seems to be rarely attempted. And I don’t have the paper in front of some notes I made. And I think it said where it was, like maybe only three papers that actually involved, you know, family or social networks in kind of Pain Rehab. So it’s almost it’s rarely done.

Jamie Johnston 36:42
Yeah, I’m just scrolling through to see if I can find it. But yeah, that’s basically what’s sad is that it’s rarely done in that way. So yeah, and I think the maybe the difficulty as well is that, you know, if we’re trying to help somebody who’s injured, the workplace isn’t necessarily going to want to talk to us. Right. So it might be a big hurdle for us to overcome, if we’re trying to engage in that way, whereas they probably be more likely to listen to a physio if they if they recall it, but hopefully, hopefully, if it’s a multidisciplinary approach, and we’re working with a physio about and with somebody, then we can have some input on that as well. But it would be, it would be great. If you know, even if you could, if you could have the person go back to work and say, hey, if your employer wants to talk to me, I’m happy to have a chat with them about, you know, what we can do to help you out, then that might be an approach where the employee is making the approach rather than us approaching the employer?

Eric Purves 37:43
Yeah, yeah. Yeah. The I think one of the barriers you do you have, though, at least in our profession here in BC, and probably throughout Canada, as well, is that nobody wants to work with the, like, WorkSafe or, like, workers compensation. Yeah. Because it’s a pain in the butt lot of paperwork for like, no pay. So even though, it’s probably would be really good to have more of this return to work, thing involved in our profession, and these opportunities to be able to go into people’s work, you know, finances are gonna are gonna win, right? Like, I could treat somebody my clinic and make this much money, you know, or I could go over here and leave my office and treat people that are returning to work and make like, totally, like, no money, almost. Right? What am I gonna do, people are gonna look after their families or unpaid bills and mortgages, food, you know, the gas, they’re going to say, in the clinic, so the idea would be not lovely to do this. But it’d be I would be so I would think that in a lot of these cases, the the money’s out there for it. Yeah.

Jamie Johnston 38:50
Absolutely. And but I mean, again, hopefully, that’s changing as well, because 10 years ago, there was absolutely no money. Yeah, to be able to do it, and now there’s a bit so hopefully, that will continue to go up and we can have more of a roll.

Eric Purves 39:05
Yeah, for sure. No, yeah, I think it definitely be beneficial. Yeah. to kind of wrap up the the the rest of this paper, they talked about the interdisciplinary bio psychosocial treatments for chronic pain, and camper did a review. And so despite their concerns about definitions of bio psychosocial interventions, camper et al found that a coordinated intervention covering several domains of the biopsychosocial model and delivered by clinicians from different backgrounds is more likely to benefit patients with chronic low back pain in the long term than his usual care or physical treatment alone. Which I thought was good because it talks about like the interdisciplinary right so involving multiple different disciplines the problem that you’re going to find me obviously in a in a like this was in a like a pain, kind of rehab or pain. in clinic, everybody’s going to all the treating clinicians are going to be working from the similar model and understanding about pain and they’re gonna stay in their lanes of what their areas of expertise and education are. What we see all the time in practice, I’ve seen other papers on this I don’t have I don’t have a reference here, unfortunately, is that there is an association between seeing too many different people. Oh, yeah, and poor longer term outcomes. But what what I understood from this and other parts of this, this paper is that you see multiple people as long as you’re working together under the same framework, to provide the best care for that person that they need. So that’s an important distinction to make. So I know oftentimes, in the courses I teach, I’m like, get the more people someone sees the less the worst, their outcomes tend to be, right clinically, as well as there’s data to support that. But doesn’t that that’s if you’re getting, I think, if you’re getting different stories different, you know, you see your physio, your car, your massage, your osteopath, your acupuncturist, your medical doctor, specialist, they’re all telling you something different. They’re all doing something different to you, and there’s no coordinated care. And that’s when you get these problems. But it seems, seems this one, if you have a singular model of care, everyone’s kind of falling as bio bio psychosocial. And they’re working together, outcomes tend to be better than doing nothing more than what they call the usual care, which is usually medications or rest.

Jamie Johnston 41:26
Yeah, and I think the, you know, I’ve seen that so many times in my career where, you know, somebody’s coming to see me on a Tuesday, they’re going to their chiropractor, Wednesday, they’re going to Doctor Thursday, they’re going to physio Friday, and they’re just appointment hopping. And the added stress that that gives them of having to go and see all these other practitioners to satisfy what the insurance company wants them to do. Is that added stress that’s taking away from a better outcome. So like you said, if it was all under one roof, and you know, it was a conjoined group of people that are trying to provide that care in a reasonable amount of time and things like that, then you’re likely to have better outcomes. But the, the current way that it’s done, or that I’ve seen is when you’re constantly hopping from practitioner practitioner appointments all week. It’s just stressing people out.

Eric Purves 42:13
Yeah. And I’ve never gonna be careful saying never and always, I very rarely have seen that benefit people by seeing multiple practitioners over time forever, years and years and years. Because we’re all just looking for that fix, right? Everything’s like, oh, my gosh, scar tissue here or this isn’t here. No, this is weak, this is tight. This is short, this is inhibited. This is out, you know, they’re constantly just being put back together is that kind of general understanding they have their body and that that rarely works. And and each practitioner is trying to make a living and rebooking people. Yeah. Money, Money Talks, right, that the financial aspect of it is is as powerful. And that’s, you know, that’s a different conversation, I guess. But that’s comes down to the ethics of it, right? We have to pay our bills. But you know, ethically, if we know better, should we still be doing that? Probably not.

Jamie Johnston 43:06
Yeah, I know. I’ve fallen on the sword a few times and told people, you’re going to hold these appointments. Don’t come and see me next week, take the day off. Yeah, take a rest. I mean, somebody else will look at it. It’s not that big of a deal. Just go take a rest. And but it always comes back to that same thing. And really what this entire paper is about is patient centered care.

Eric Purves 43:24
Yeah, yeah. Based on its care, and providing team based care seems to be the thing too, right, that involves all of the domains. And it’s what I understand is it seems very difficult for one specific professional to treat all domains because we’re not educating them. We’re not We’re not bio psychosocial therapists. It’s not like its own brand is. It would be attendance. Yeah. Well, it’s, it would be a 10 year course.

Jamie Johnston 43:50
Yeah. Oh, manual therapy, and psychotherapy and social therapy, you’d be. So not it’s not a terrible thing. But you’d be in school for a long time to be able to do all that.

Eric Purves 44:00
So yeah, I think what we should get from this is that, you know, we have to start thinking about psychosocial, thinking, there’s a lot of influences on people. We never want to just say it’s just the bio, we don’t wanna swing too far. We don’t say it’s just a psychosocial we want to kind of, you know, play in that middle. There’s a pendulum swinging too far and be aware of, you know, is this more of a bio driver? Oh, yeah, you’ve got it. Like there’s tissue injury, there’s inflammation, there’s brake, there’s whatever, there’s something you know, or is this more like, is there more psychosocial things going on that are amplifying kind of some of that nociceptive sensory stuff that’s going on? Right. These things all work together. And it’s, you know, part of the problem we see in the research as well as what we see in these online discussions is, it’s like one swing to the right of one swing to the left, it goes back and forth. Right. And, you know, the quote that the authors use here, which I thought was great, it said when they’re talking about bio psychosocial interventions, it says, working closely together with regular team meetings, face to face or online agreement on diagnosis. therapeutic aims and plans for treatment and review is important to know the emphasis on the need for the treatment team to reach agreement on diagnosis goals and treatment plans, hopefully, before the plan is implemented. And this is just basically saying like, this is what you should be doing and ultimately, multidisciplinary treatment environment. But that in reality, at least for our profession, I, we’ve lived our lives before, that’s very difficult. When you’re one on one with person in a room for 45, 60 minutes, and you’re busy and everyone else is busy. It’s very, very difficult to coordinate care appropriately, at least the way things are set up here. But ideally, in a proper pain clinic. This is how things should be done. And I think some places they’re the only I got I can’t speak from my own knowledge, but I would hope that some places they do things that way.

Jamie Johnston 45:50
Yep. Yeah, hopefully, it’s, hopefully that’s coming. But we know how long it takes to implement research. So as long as as long as as long as we’re working towards providing better care whether it’s individually or as a team. And as long as we’re going after patient centered care, then hopefully that means we’re doing whatever’s best for the person in front of us.All right, everybody. We’ll we’ll see you next time on the podcast.

We hope you enjoyed this podcast. These kinds of topics are what we’re all about. If you’d like to learn more, go to our websites, themtdc.com or ericpurves.com. If you know of any other therapists that could benefit from this, please tell them to subscribe.


Nicholas, Michael K.. The biopsychosocial model of pain 40 years on: time for a reappraisal?. PAIN: April 19, 2022 – Volume – Issue – 10.1097/j.pain.0000000000002654
doi: 10.1097/j.pain.0000000000002654

Articles Of The Week January 16, 2022

So normally these posts are full of articles we’ve scoured the internet to find. However, this link is a really useful tool we can all use for research papers. This google chrome extension actually makes it so you can get access to research papers you may not have been able to access before. Download it and see how many more papers you can get access to.

Unpaywall: An open database of 31,026,169 free scholarly articles. – Google Chrome

We talk lots about the benefits of movement when it comes to helping patients dealing with pain. This is an inspiring story of someone who has RA and finds that going to the gym and lifting weights is helpful in their pain journey. While we always want to take an individualized approach (as this story may not work for every person who has RA) this is a great story of resilience and someone not letting their diagnosis define them.

Rheumatoid Arthritis and Strength Training – Starting Strength

Do you have any patients who need help with TMJ pain? This is a great youtube video that not only gives a great description of how the TMJ works, pain referrals, reasons for extraarticular problems, and even some massage and exercise. This could be a good resource to share with patients.

Exercises and massage for temporomandibular joint dysfunction – Dr. Andrea Furlan

There is a big push in our profession towards evidence-based practice (which I’m clearly a fan of). In order for us to do this there are some things we need to recognize like, where did our beliefs come from, do we need evidence, and why research evidence? Then of course there are logical fallacies and other things we need to unpack. This article has some great takeaways we can use and also does this from a very humble standpoint.

On Beliefs vs. Evidence – Michael Rey

A lot of therapy is now going online and this is a great new program out of Ireland helping people reduce the risk of falls. “Our programme teaches people how to analyse their falls and what caused it and gives them management strategies to prevent future falls.” While it is only a pilot programme they are getting some good results, so down the road, we may be able to refer some of our patients to a program like this.

Pilot online exercise programme aims to reduce risk of falls – David Raleigh